Bugs of Summer

Asking Christopher Ohl, MD, about the bugs that can disrupt an outdoor experience is like asking an astronaut about space – he's in his element.

Ohl, an infectious diseases specialist with Wake Forest Baptist Health, is quick to point out that the vast majority of ticks and tick bites are not harmful, that covering up is the surest way to avoid most bug bites, and that, given his druthers, he'd rather suffer a tick bite than be stung by a bee. "Because bee stings hurt; they really hurt.''

Ohl took time to share his thoughts and provide some information on common infectious disease spreading pests.


Rocky Mountain Spotted Fever

The epicenter for this tick-borne disease in the United States is Wilkes County, North Carolina.

Usually, if you have a warmer winter, then you get more ticks. A warm winter with a wet spring tends to make it worse.

Although very few ticks carry the infectious disease Rocky Mountain spotted fever, if you should get a fever a week after receiving a tick bite, you should see a doctor to be safe.

How You Get Tick Bites

Ticks like grassy, bush areas and areas that have been disturbed. People who get ticks are generally doing outdoor activities in those areas; they're clearing brush, mowing a lawn or hiking.

The tick grabs hold of a piece of grass, a leaf, or brush with its back legs and then feels for vibrations. It puts its front legs out to grab hold of something that walks by.

Then, it will crawl up the individual that it grabbed, get underneath the clothing and try to find a place where it's not going to get knocked off - in and around the groin, the armpit, the back, and the hair.

Once in place, it will attach, burying its proboscis through the skin, and after 72 hours or so of feeding (on human blood), it will generally drop off.

How to Detach a Tick

The worst way to remove a tick is to just grab it with your fingers, squeeze it and pull because actually squeezing the tick sends the juices into you, like a little needle and syringe.

Instead, you should use tweezers and grab it right down next to your skin where the head is, gently pull and most of the time the head will come out. If you just try to rip the tick off, the head stays in and that can become an irritant.

How to Avoid Ticks

There are a few things you can do to prevent tick bites.

After you've been in an outdoor activity, do a self-check, or a buddy check, for ticks. If you do it right after your activities, then the ticks haven't attached yet and you can just flick them off.

Another thing you can do is wear proper clothing, for instance tight-fitting pants. If the ticks can't get under your clothes, they can't bite you. You can tuck your pants leg into your socks and that helps too.

You can use a mosquito repellant with 30 to 35 percent DEET (diethyl-meta-toluamide), which helps repel ticks.

Lastly, you can soak your clothes in something called Permethrin. You just spray Permethrin on your clothing until it becomes damp. Permethrin is an insecticide and it actually kills the tick.


The best way to avoid bee stings is simple - don't mess with the bees.

However, sometimes we inadvertently do, like when we mow the grass. The best way to protect yourself from bee stings is to cover as much as you can.

Only a small number of people have bee sting allergies. People can see an allergist and get tested if they believe they have one. And if they truly are allergic, they are given an epinephrine pen to carry around with them.

Bees don't really transmit disease. Most of the time, you don't have to do anything other than wash with soap and water.


Occasionally we will have some mosquito-borne infections in North Carolina. Generally these are viral infections. The one that's been in the news in the past decade is West Nile. There are still sporadic cases of West Nile in North Carolina but they are now rare and unusual.

The best way to protect yourself from mosquito bites is to cover as much skin as possible (with clothing) and then use a 30 to 35 percent DEET-containing insect repellant. The lotions work better than the sprays.

Mosquito Safety for Children

There are repellants that are specifically for kids. The DEET concentration is a little bit lower. But if the mosquitoes are really out and about and the nuisance factor is high, you can safely put 30 to 35 percent DEET on a child.

There's another product out there that has picaridin in it. If you really can't stand the greasiness and the smell of DEET, you can use picaridin. It doesn't smell as bad, but you have to apply it a little bit more often.

This will protect you from getting bit, make your experience much more pleasant and reduce the risk of rare viral infections.

Protecting Your Yard from Mosquitoes

Sometimes I get asked, “Can I treat or spray my yard?”

It's not very green to use an insecticide in your yard. And you're killing a lot of beneficial insects as well, including ladybugs, that help your garden out. So I'm not a big proponent of yard treatments.

People also ask about mosquito traps. They tend to attract more mosquitoes into the area. I don't think they work very well.

Citronella candles smoke, and smoke deters mosquitoes. They do work to some extent, but they're only going to work in a focused area.